Kornimate/medical-research-clean huggingface dataset:
treosulfan-based conditioning for allogeneic stem-cell transplantation (sct) in lymphoid malignancies

Conditions: Non Hodgkin Lymphoma; Hodgkin Lymphoma

Summary: the study hypotheses is that the introduction of dose escalated treosulfan, in substitution to busulfan or melphalan, will reduce toxicity after allogeneic transplantation while improving disease eradication in patients with lymphoid malignancies not eligible for standard transplantation.


Eligibility criteria:
inclusion criteria: 1. age less than physiologic 68 years. 2. patients with nhl and hl with an indication for allogeneic transplantation as follows: * aggressive lymphoma and hodgkin lymphoma; relapse after autologous transplants * follicular lymphoma; failure of at least one prior regimen 3. disease must be at chemo-sensitive or stable status to prior therapy before transplant. 4. patients must have an hla matched related or unrelated donor willing to donate either peripheral blood stem cells or bone marrow. matching is based on high-resolution class i (hla-a, -b, -c) and class ii (hla-drb1, -dqb1) typing. the goal is to transplant \> 3 x 106 cd34+ cells per kg body weight of the recipient 5. patients must sign written informed consent 6. adequate birth control in fertile patients exclusion criteria: 1. overt progressive disease prior to transplantation. 2. bilirubin \> 3.0 mg/dl, transaminases \> 3 times upper normal limit 3. creatinine \> 2.0 mg/dl 4. ecog-performance status \> 2 5. uncontrolled infection 6. pregnancy or lactation 7. abnormal lung diffusion capacity (dlco \< 40% predicted) 8. severe cardiovascular disease 9. cns disease involvement 10. pleural effusion or ascites \> 1 liter 11. known hypersensitivity to fludarabine or treosulfan 12. psychiatric conditions/disease that impair the ability to give informed consent or to adequately co-operate
neurotomy to treat synkinesis following peripheral facial palsy

Conditions: Facial Paralysis; Facial Palsy; Peripheral Facial Palsy; Peripheral Facial Paralysis; Bell Palsy; Synkinesis

Summary: the purpose of this study is to evaluate neurotomy as an alternative treatment to botox injections for severe synkinesis following peripheral facial palsy

patients with severe synkinesis treated at karolinska university hospital with botox injections with unsatisfying results are invited to participate in this study aiming to evaluate surgical neurotomy to synkinesis causing branches of the facial nerve. surgical procedure: small branches of the facial nerve are identified under microscopic magnification. using a precise nerve stimulator the movement each nerve branch elicits is evaluated as normal or synkinetic. pathological branches are then parted while normal functioning nerve branches are left intact. evaluation procedure: study participants are measured in a multimodal manner at 5 different time points during the study period; at study start, with and without botox effect before surgery, and at 6 and 12 months after surgery. evaluation methods: * clinical evaluation with sunnybrook facial grading scale, blinded to observer from video recordings at the end of the study * neurophysiological measurements, * quality of life, measured with validated questionnaires face, fdi, saq * reports of potential side effects, using clavien-dindo classification as well as free text

Eligibility criteria:
inclusion criteria: * synkinesis following peripheral facial palsy * sunnybrook score \<61 * botox injections at least 3 times a year * have received at least 3 botox injections * botox injections not satisfying treatment * read and signed written consent exclusion criteria: * synkinesis since less than 2 years * contractures in facial muscles * other planned surgery in the face during study period * smoking * uncontrolled hypertension * diabetes mellitus * pregnancy or breast feeding * severe systemic disease (asa 3-4)
ttv-based management of long-term immunosuppression in kidney transplantation

Conditions: Infection; Cancer; Rejection; Kidney Transplantation

Summary: long-term outcomes in kidney transplantation remain a significant challenge, as complications such as donor-specific antibodies (dsa), antibody-mediated rejection, infections, and cancer increasingly threaten graft and patient survival over time. the development of non-invasive biomarkers to guide the management of therapeutic immunosuppression beyond the first year post-transplantation is therefore a crucial unmet need. torque teno virus (ttv), a non-pathogenic virus with a high prevalence worldwide, has emerged as a promising biomarker in this context. its replication inversely reflects immune control by t cells, correlating with the depth of therapeutic immunosuppression. additionally, its slow replication kinetics make ttv dnaemia a useful marker for evaluating patient adherence to immunosuppressive treatments. the taoist study tests whether longitudinal monitoring of ttv dnaemia every three months, starting from the second year after transplantation, can guide the personalization of immunosuppressive therapy. the primary endpoint is the time to the first occurrence of complications linked to inadequate immunosuppression, including dndsa, biopsy-proven rejection, infection, cancer, or graft loss. secondary objectives include evaluating the acceptability of ttv dnaemia among healthcare professionals and assessing its cost-effectiveness compared to standard care. an ancillary objective examines the link between ttv dnaemia and the immunosuppressant possession ratio (ipr) to explore its potential as a marker of treatment adherence.


Eligibility criteria:
inclusion criteria: * adult ≥ 18 years-old * recipient of a kidney allograft (third graft at most) * 12 to 48 months post-transplantation * stable graft function (defined as: delta creatininemia over the previous 6 months \< 20% and proteinuria \< 30mg/mmol) * on maintenance immunosuppression, which includes cni (cyclosporin or tacrolimus) and mmf (cellcept or myfortic) with or without corticosteroids * detectable ttv dnaemia at enrollment * no circulating dsa in solid phase assay * undetectable bkv dnaemia at enrollment * written informed consent exclusion criteria: * recipient of an hla identical graft * mutiple organ transplantation or functional transplant other than kidney * maintenance immunosuppression that includes a mtor inhibitor, belatacept or imurel * presence of histological sign of active rejection (i+t \> 2 and g+cpt \> 2) on graft biopsy performed within 3 months before enrollment * uncontrolled infection at inclusion * infection requiring hospitalization or vaccination within 3 months before inclusion * pregnant, unwillingness to practice adequate contraception or patient with a pregnancy plan during 3 years of study * person not affiliated to a social security scheme or beneficiary of a similar scheme * person subject to a legal protection measure (guardianship, curatorship) or deprived of liberty

Keywords: ttv biomarker immunosuppression precision medicine kidney transplantation
parkinson's disease therapy using cell technology

Conditions: Transplantation:Mesenchymal Stem Cell Transplantation

Summary: treatment of patients with parkinson's disease using mesenchymal stem cells is a perspective method to influence on the pathogenesis of the disease. at the same time, this is a complex and still insufficiently explored process. autologous mesenchymal stem cells will be transplanted to 30 patients with parkinson's disease. the results of the effectiveness of the combined and intravenous routes of mesenchymal stem cells administration on the motor and non-motor symptoms in these patients will be evaluated and compared with the results of control group that received placebo therapy


Eligibility criteria:
inclusion criteria: 1. a reliable diagnosis of parkinson's disease, according to the diagnostic criteria developed by the brain bank of the society for parkinson's disease of great britain (uk brain bank criteria, 1992). 2. stage of the disease according to hen-yar: 1.5 - 3.0 stage. 3. rapidly progressive type with a change in the stages of parkinson's disease in no more than 4 years. 4. a good response to levodopa treatment: a positive dopamine test for assessing motor functions by a total score of section 3 of the updrs scale in the on- and off-period (not less than 30%). 5. the duration of the disease is not more than 8 years with the absence of motor fluctuations and dyskinesias. 6. the age of patients is up to 65 years exclusion criteria: e and parkinsonism-plus. 2. severe concomitant diseases (congestive heart failure, myocardial infarction, pneumonia, decompensated diabetes mellitus, cachexia, etc.). 3. autoimmune diseases, a tendency to bleeding, a history of sepsis. 4. oncological diseases. 5. the presence of acute or exacerbation of the chronic inflammatory process of the sinuses or oral cavity. 6. a positive result for hiv, hepatitis b (hbv), hepatitis c (hcv), syphilis (rw). 7. cognitive deficit. 8. mental disorders - hallucinations, behavior disorders. 9. depression of a pronounced degree (not more than 19 points on the hamilton scale). 10. alcoholism, drug addiction, criminal liability in the patient's history. 11. pregnancy, lactation.

Keywords: parkinson's disease mesenchymal stem cells intranasal transplantation intravenous transplantation tandem transplantation
diagnosis, treatment and outcome of lung cancer patients

Conditions: Non Small Cell Lung Cancer; Small-cell Lung Cancer

Summary: observational, prospective clinical research, multi-center clinical research platform with the main objective to assess molecular biomarker testing, treatment and outcome of patients with nsclc or sclc in turkey

in turkey, non-small cell lung cancer (nsclc) is the most common cause of cancer-related death in men and one of the most common causes of cancer-related deaths in women. because of the heterogeneity of nsclc or sclc, it is crucial to characterize the biology of the tumor as exact as possible, to predict the course of disease as accurate as possible, and to determine the optimal therapeutic algorithm as early as possible after initial diagnostic work-up. these efforts are an obligatory part of the initial diagnostics, since thorough knowledge of the biology of the disease and the resulting therapeutic options ensure optimal care of volunteers with nsclc or sclc. the aim of registurk is to set up a national clinical research platform to document molecular testing, treatment and course of disease of patients with nsclc or sclc.

Eligibility criteria:
inclusion criteria: 1. patient histopathologically diagnosed with non-small cell lung cancer or small cell lung cancer 2. written informed consent no later than six weeks after start of first-line treatment 3. age ≥ 18 years exclusion criteria: * volunteers participating in a research program for non-small cell or small cell lung cancer that includes interventions outside of routine clinical trial

Keywords: non-small cell lung cancer small cell lung cancer immunotherapy progression free survival survival
evaluation of volume status changes in children on regular hemodialysis at assiut university children,s hospital

Conditions: Volume Status in Chronic Kidney Diseases

Summary: chronic kidney disease (ckd) is a major health problem worldwide.(1) chronic renal failure is defined as a decrease in glomerular filtration rate (gfr) of less than 60 ml/min/1.73 m2 of body surface evolving for more than 3 months

chronic kidney disease (ckd) is a major health problem worldwide.(1) chronic renal failure is defined as a decrease in glomerular filtration rate (gfr) of less than 60 ml/min/1.73 m2 of body surface evolving for more than 3 months . the etiologies of ckd in children are three main groups of pathologies: congenital anomalies of the kidney and urinary tract , hereditary nephropathies and acquired causes . (2) complication of pediatric hemodialysis is chronic fluid overload, left ventricular hypertrophy ,hypertension, heart failure, decrease arterial flexibility and often results in increase chance of morbidity and mortality, so fluid overload must be prevented .(3) lung ultrasonography is the most recent, safe, easy, and reliable technique . the most commonly observed finding is a comet tail fanning out from the lung-wall interface and spreading upwards to the edge of the screen, named a "b-line" chest sonar advantages include its noninvasiveness , ease of use, availability of portable machines, avoidance of radiation detect lung edema even in initial non symptomatic cases known as hidden lung congestion .(4) bioimpedance analysis (bia) bio impedance spectroscopy (bis) is a technique used to estimate total body water, extracellular water, lean and adipose tissue mass and over hydration . (5) n-terminal pro-brain natriuretic peptide is used as a biomarker to aid to predict cardiac dysfunction in children and adolescents .(6)it is an effective marker of volume status in patient with or without reduced ejection fraction undergoing hemodialysis. (7)

Eligibility criteria:
inclusion criteria: - patients aged 3 to 16 years having end stage renal disease undergoing regular haemodialysis for at least more than 6 months of both gender were enrolled exclusion criteria: * patients with chronic lung disease ,or pulmonary infection in the last 2 months were excluded from study. patients with congestive heart failure patients with pulmonary edema patient with pericardial effusion parental refusal to participate
dna microarray analysis of gene expression in chronic rhinosinusitis

Conditions: Chronic Rhinosinusitis w/o Nasal Polyps

Summary: analysis of differential gene expression in patients with chronic rhinosinusitis without polyps compared to unaffected patients. correlation of abnormal gene expression with surgical outcomes.


Eligibility criteria:
affected patients: * two or more of the following symptoms should be present for 12 weeks or more: anterior mucopurulent drainage, posterior mucopurulent drainage; nasal obstruction; and facial pain-pressure-fullness. * signs of nasal inflammation such as discolored mucus, edema of the middle meatus or ethmoid area should be documented by endoscopy. * the symptoms of rhinosinusitis have failed to resolve or have recurred after a treatment course with antibiotics and nasal and/or oral steroids. * the diagnosis of rhinosinusitis should be confirmed with a ct scan. * patients deny recent (within one year) cigarette smoking or exposure to inhaled substances that are potentially harmful to respiratory epithelium * patients were not previously diagnosed with reactive airway disease or aspirin sensitivity. * patients also must meet the standard criteria for endoscopic sinus surgery and scheduled to undergo their procedure at mmc. unaffected patients: patients undergoing elective nasal surgery at mmc. * patients deny symptoms of allergic rhinitis such as nasal congestion, nasal discharge, itching, sneezing. * patients deny symptoms of chronic or acute rhinosinusitis such as nasal obstruction, facial pain-fullness-pressure, anosmia, anterior and/or posterior mucopurulent drainage. * nasal endoscopy showed no evidence of nasal inflammatory disease, such as erythema, edema, polyps, or discolored mucus. * patients do not have history of prior sinus surgeries and were not previously diagnosed with crs. 1. patients deny recent (within one year) cigarette smoking or exposure to inhaled substances that are potentially harmful to respiratory epithelium. 2. patients were not diagnosed with reactive airway disease or aspirin sensitivity. * the absence of evidence of inflammation, such as inflammatory infiltrate or epithelial dysplasia on histopathologic exam of nasal mucosa obtained during surgical procedure.
extracorporeal membrane oxygenation in the therapy of cardiogenic shock

Conditions: Cardiogenic Shock

Summary: eligible patients with severe cardiogenic shock will be randomized to one of the two arms: immediate ecmo therapy or early conservative therapy. in the invasive group, veno-arterial ecmo will be implanted according to the local practice with flow settings to ensure sufficient tissue perfusion. with the exception of ecmo implantation in the invasive group, all other diagnostic and therapeutic procedures will be done according to the current standard of care at the tertiary cardiovascular center, including other cardiovascular interventions (i.e. percutaneous coronary intervention or cardiac surgery). implantation of other mechanical support devices including ecmo in the primary conservative group is allowed in the case of shock progression with rise of serum lactate by 3 mmol/l in comparison with the lowest value during the past 24 hours. follow-up include visits at 30 days, 6 moths and 12 months.


Eligibility criteria:
inclusion criteria: patients must fulfil criteria for rapidly deteriorating (a) or severe (b) cardiogenic shock: a. rapidly deteriorating cardiogenic shock is defined as progressive hemodynamic instability necessitating repeated bolus administration of vasopressors to maintain mean arterial pressure \> 50 mmhg + impaired left ventricle systolic function (left ventricle ejection fraction (lvef) \< 35% or lvef 35-55% in case of severe mitral regurgitation or aortic stenosis) or b. in severe cardiogenic shock all following criteria should be met: 1. hemodynamic: cardiac index (ci) \ 0.1 μg/kg/min + dobutamin dose \> 5 μg/kg/min or systolic blood pressure \ 0.2 μg/kg/min + dobutamin dose \> 5 μg/kg/min + (lvef \< 35% or lvef 35-55% + severe mitral regurgitation or aortic stenosis) 2. metabolic: lactate - two consecutive values ≥ 3 mmol/l (with at least 30 min between samples), with non-decreasing trend on steady doses of inotropes and/or vasopressors or svo2 - two consecutive values \< 50% (with at least 30 min between measurements), with non-increasing trend on steady doses of inotropes and/or vasopressors 3. hypovolemia must be excluded: central venous pressure \> 7 mmhg or pulmonary capillary wedge pressure \> 12 mmhg exclusion criteria: 1. age \< 18 years 2. life expectancy lower than 1 year 3. high suspicion of pulmonary emboli or cardiac tamponade as a cause of shock 4. significant bradycardia or tachycardia which might be responsible for hemodynamic instability and not treated by pacing or cardioversion 5. cardiac arrest survivors remaining comatose 6. hypertrophic obstructive cardiomyopathy 7. peripheral artery disease disabling insertion of outflow cannula to femoral artery 8. moderate to severe aortic regurgitation 9. aortic dissection 10. uncontrolled bleeding or timi major bleeding within last 6 months 11. known encephalopathy
a psychopathological study of latent (early) schizophrenia: clinical pathology/neuropsychological dysfunctions

Conditions: Schizophrenia; Latent Schizophrenia

Summary: current diagnostic criteria of schizophrenia are based on marked positive and negative symptoms. this definition may impede the exploration of basic phenomenological psychopathology or pathological mechanism of schizophrenia. schizophrenia was found to have neuroanatomical, neurophysiological and neuropsychological impairment. however, the existence of these basic pathological states may not manifest as clinical state of schizophrenia, and it is found in normal relatives of schizophrenia proband. the clinical state of this underlying pathology may include so-called latent or early, or pseudo-neurotic schizophrenia or schizotypal disorder. the manifestation of prominent neurotic symptom state may not only present as an psychopathological issue, but also induce misdiagnosis in clinical practice. this may interfere early diagnosis of schizophrenia and may delay the chance of early and appropriate treatment. taking the fact of this disadvantaged conditions, this research is for exploration of clinical pathology and neuropsychological functions of latent or pseudo-neurotic schizophrenia. the strategy ia a natural follow-up study on the clinical cases obtained from the registration record of the medical charts of the national taiwan university hospital from 1970 to 1995. the natural follow-up results till study time (5 yrs to 30 yrs following period) will be explored. by using neurotic group (50 cases), latent schizophrenia group (50 cases) and schizotypal group (30 cases), the differences in clinical pathology, neuropsychological functions and family history of schizophrenia will be examined. there are 5 hypotheses to be tested: (1) schizotaxia may exist as the manifestations of latent schizophrenia, schizotypal disorder and frank schizophrenia. the severity of pathology increased step by step; (2) the syndrome may change from the lower order to higher order to higher order, but not all of them changed to the higher order; (3) the clinical pathology of latent schizophrenia has both neurotic symptom as well as basic symptoms of schizophrenia; (4) there is the same kind of neuropsychological impairment of schizophrenia in the group of latent schizophrenia, and (5) the prevalence of schizophrenia in the first degree relatives of latent schizophrenia is higher than that of the general population. finally, this study results will help the establishment of valid screening and/or diagnostic method (criteria) of latent schizophrenia for clinical and research usage.


Eligibility criteria:
inclusion criteria: * schizophrenia * latent schizophrenia exclusion criteria: -

Keywords: schizophrenia latent schizophrenia schizotypal disorder psychopathology neuropsychological function family history nosology basic symptoms
sleep quality after stellate-ganglion block of patients undergoing breast cancer operation

Conditions: Sleep Deprivation

Summary: stellate-ganglion block have been done safely for more than 60 years. it has proved to provide survivors of breast cancer with relief from hot flushes and sleep dysfunction with few or no side-effects. the aim of the present study is to evaluate postoperative sleep quality of patients undergoing breast cancer surgery with stellate-ganglion block performed in the operation.

this study is a prospective, randomized, controlled (randomized, parallel group, concealed allocation), double-blinded trial. all patients undergoing breast cancer operation will be randomized 1:1 to the treatment intervention with general anesthesia as an adjunct to stellate-ganglion block with 0.25% ropivacaine hydrochloride or saline. the objective of the trial is to evaluate the postoperative sleep quality of patients undergoing breast cancer operation with stellate-ganglion block 0.25% ropivacaine hydrochloride or saline.

Eligibility criteria:
inclusion criteria: * at least18 years and pre-menopausal; * scheduled to undergo elective breast cancer operation; * american society of anaesthesiologists (asa) risk classification i-ii. exclusion criteria: * (1) patient refusal; (2) known hypersensitivity to the study medication (ropivacaine); (3) long-term use of opioids; (4) a history of psychiatric or neurological disease; (5) a preoperative pittsburgh sleep quality index (psqi) global score higher than 6.

Keywords: bispectral index regional cerebral oxygen saturation stellate-ganglion block